Analysis of Risk Factors and Clinical Treatment of Placental Adhesions
Objective To explore the risk factors and ideal treatment of placental adhesion.Methods From May 2022 to November 2023,100 parturients who underwent vaginal delivery in Xinfeng County People's Hospital were selected as the research objects.According to the occurrence of placental adhesion,they were divided into placental adhesion group and non-placental adhesion group.The basic information and pathological examination results of the two groups were collected,the risk factors of placental adhesion were analyzed,and the relevant nomogram prediction model was constructed and verified.The patients in the placental adhesion group were divided into group A and group B by random number table method.Group A was given oxytocin umbilical vein injection,and group B was given ergometrine maleate intramuscular injection.The therapeutic effects of the two groups were compared.Results There were 38 cases in the placental adhesion group and 62 cases in the non-placental adhesion group.There were significant differences in age,pregnancy complications,parity,cesarean section history,abortion history,placental thickness,placental length and placental width between the two groups(P<0.05).Multivariate logistic analysis showed that age,history of cesarean section,history of abortion,placental thickness,placental length and placental width were independent risk factors for placental adhesion P<0.05).According to the above risk factors,a nomogram prediction model of placental adhesion was established.The ROC curve showed that the model discrimination AUC=0.807(95%CI:0.752-0.843),and the calibration curve showed that the slope of the calibration curve was close to 1,and the model prediction effect was good.After treatment,the natural placental detachment rate in group A was higher than that in group B,and the rate of taking placenta by hand was lower than that in group B(P<0.05).Conclusion Maternal age,history of cesarean section,history of abortion and placental thickness,length and width are risk factors for placental adhesion.The nomogram prediction model based on the above factors has good predictive efficacy.Intravenous injection of oxytocin through umbilical vein has a good clinical effect in the treatment of this disease.
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